Patient Information >>
How Hospitals Are Paid
Little Falls Hospital is under a system of reimbursement known as DRGs (Diagnostic Related Groups). Hospitals are paid a fixed reimbursement according to your diagnosis or surgical procedure, rather than by the number of days you are hospitalized, or the particular services provided during a hospital stay.
This may result in a difference between the charges you incurred during your stay and the amount you or your insurance carrier will be billed. The DRG system assumes that patients with similar illnesses and injuries require approximately the same care and treatment.
About Your Bill:
Hospitalization coverage is a contract between a patient and his/her insurance company. Most forms of hospitalization insurance and Medicaid and Medicare are accepted. You are ultimately responsible for that portion of your care that insurance does not cover.
No patient in need of hospital care will ever be turned away from Little Falls Hospital because of an inability to pay for that care. Your bill will be handled by individuals who are knowledgeable about your account and your insurance carrier. Their direct telephone number can be found on your statement. Please call the business office should you have any questions or if you expect to have difficulty paying your hospital bill.
You should also be aware that your bill does not include professional services rendered by your private physician or surgeon, or by other specialties such as anesthesiology, Emergency Department physicians, x-ray interpretation, pathology, private duty nurses or transportation. Charges for a telephone and the use of a television are paid when services are rendered.
For your convenience, the hospital accepts MASTERCARD and VISA as payment.
Credit Policy:
Little Falls Hospital will assist you in making arrangements for payment of hospital services. Financial counselors will assist you prior to admission, during your stay, and/or at the time of discharge.
About Insurance:
For your convenience, the hospital will bill your insurance company on your behalf to obtain payment for those services covered in your policy. Please note that you are responsible to see that the bill is paid and the hospital may look to you for payment if a timely payment is not received from your insurance carrier.
In addition, you may, more than likely, be responsible for non-covered items such as private room differentials and deductible amounts. Balances remaining after insurance payment are due upon receipt of your statement unless other arrangements have been made with the Billing Office.
About Direct Payment (No Insurance or Insurance Not Adequate):
If you do not have insurance or it is known that your insurance is not adequate for the service being rendered, you should be prepared to pay your account. If you are unable to make payment, the Billing Office will assist you in making financial arrangements.
Additional Information:
Each time you receive services from the hospital, you are assigned a new account number. To ensure proper credit to your account, please refer to the appropriate account number on all relating payments and correspondence.
Child Health Plus:
To help expand children's access to health care, New York State is subsidizing health insurance for children of the working poor under the age of 19. These children are not receiving Medicaid and lack private health care coverage because their parents do not receive health insurance benefits from their employers, and cannot afford the high cost of private premiums.
Child Health Plus currently covers well-child care, immunizations, x-rays and lab tests, inpatient and outpatient services for the diagnosis and treatment of illness or injury, emergency care, prescription drugs, physical and occupational therapy, and outpatient treatment for mental health and alcohol or substance abuse.
Parents interested in learning more about Child Health Plus or enrolling their children, may call the Herkimer County Public Health Prevention Unit. |
